Remote Medical Director - Health Plan Medical Policy
$174.07k - $374.92kHispanic Alliance for Career Enhancement
- Remote job
Hispanic Alliance for Career Enhancement seeks a Medical Director to oversee medical policy and support medical management programs in Arizona. This fully remote role requires an active medical license and at least two years of experience in health care delivery. Responsibilities include engaging with clinical teams, conducting reviews, and participating in on-call rotations. The salary ranges from $174,070 to $374,920, with a comprehensive benefits package available. #J-18808-Ljbffr Hispanic Alliance for Career Enhancement
- ...FLR PCHP - Parkland Community Health Plan Remote PRIMARY PURPOSE Oversees medical coordination required for... ..., Quality Management, Clinical Policy, Technology Assessment, Credentialing... ...Texas for Managed Care Medical Directors. Board certification in the...Remote workPolicyHealth InsuranceContract workWork at officeLocal area
$124k - $211k
...Director Health Plan Underwriting - REMOTEAt Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a... ...legal, regulatory, and contractual requirements and internal policies and procedures.Every employee must be able to perform the essential...Remote workPolicyHealth InsuranceContract workWork experience placementLocal areaWork visa$102.16k - $199.22k
...industry standards, and Molina internal policies, and prevents and/or detects violation of... ..., and resolution.Enforces the compliance plan, code of conduct and anti-fraud plan.In conjunction... ...QualificationsPrevious experience in a health plan or government programs setting (...Remote workPolicyHealth InsuranceWork experience placementWork at office$248.5k - $373k
...we're simplifying the health care experience, creating... ...and Grievances Medical Director is responsible for ongoing... ...the flexibility to work remotely * from anywhere within... ...for various health plan and insurance products... ...clinical criteria of medical policies Perform Department of...Remote workPolicyHealth InsuranceMinimum wageFull timeWork experience placementLocal areaWork from home- ...Reviewer to join our Group Health division. The role is... .../NCD Client-specific policies Produce clear, concise,... ...similar Active, unrestricted medical license Prior... ...preferably in a health plan or IRO environment Familiarity... ...Work Environment Remote work from home Full-time...Remote workPolicyHealth InsuranceFull timeTemporary workWork at officeWork from homeMonday to FridayNight shift
$248.5k - $373k
...we're simplifying the health care experience, creating... ...flexibility to work remotely from anywhere within... ...Appeals and Grievances Medical Director is responsible for ongoing... ...for various health plan and insurance products... ...criteria of medical policies. Perform Department of...Remote workPolicyHealth InsuranceMinimum wageWork experience placementLocal areaWork from home$248.5k - $373k
...Appeals And Grievances Medical Director At UnitedHealthcare... ...we're simplifying the health care experience,... ...the flexibility to work remotely from anywhere within the... ...grievances for various health plan and insurance products... ...criteria of medical policies. Perform Department...Remote workPolicyHealth InsuranceMinimum wageWork experience placementLocal areaWork from home$180.8k - $226k
...individual for the position of Director Health Planning for the design practice, to... ...benefit package including medical, dental and vision coverage... ...off, flex‑time schedules, remote work options and a 401k... ...and adhere to our internal policies and our Code of Conduct. CannonDesign...Remote workPolicyHealth InsuranceFor contractorsWork experience placementFlexible hours$130 - $140 per hour
...Remote Medical Director - Utilization Management (6-12 month contract, potential for long-term hire... ...partnering with a premier national health plan to identify an experienced Medical Director... ...cases utilizing established medical policy criteria, ensuring clinical accuracy....Remote workPolicyHealth InsuranceHourly payContract workFlexible hours- ...Job Title: Medical Director – Utilization Management (Contract to Hire) Location: Fully Remote (U.S. Only) Work Authorization: U.S. Citizen... ...cases against medical policy criteria to determine medical... ...utilization management experience Health plan / insurance experience...Remote workPolicyHealth InsuranceContract workFlexible hours
- ...Medical Director – Utilization Management Remote | Full-Time (40 hrs/week) We are partnering with a national health plan organization to identify an experienced Utilization Management Medical... ...adherence to regulatory and medical policy standards. This is a production-...Remote workPolicyHealth InsuranceFull timeContract workImmediate start
- ...Job Title: Medical Director - Utilization Management Location: Remote - Preference EST or nearby Pittsburgh... ...using Medical Policy criteria sets to evaluate... ...Management experience within a health insurance environment.... ...a Health Insurance Plan. Strong knowledge...Remote workPolicyHealth InsuranceContract workPrivate practice
- ...Now Hiring: Medical Director – Utilization Management 100% Remote | Must work PST hours Medicare Advantage... ...(SNF, IRF, LTACH, Home Health) Apply MCG / InterQual... ...in developing medical policies and UM protocols Maintain... ...managed care or health plan environments Excellent analytical...Remote workPolicyHealth InsuranceImmediate start
$275k
...Medical Director, Hematology/Oncology (Utilization Management & Clinical Strategy) Full-Time Remote (Post-Onboarding) U.S. Licensed MD/DO A nationally... ..., hospitals, and health plan stakeholders. Key Responsibilities... ..., MCG, or clinical policy guidelines Previous...Remote workPolicyHealth InsuranceFull timeRelocation packageMonday to Friday$190k - $200k
...seeking a board‑certified Medical Director (Internal Medicine or... .... This role is fully remote and focuses on... ...needed. Consult on SUD policy and MCM cases when required... ...organizations, marketplace plans, or corporate UM.... ...with AmBetter or other health plan operations....Remote workPolicyHealth InsuranceFull time- ...DESCRIPTION Job SummaryProvides medical oversight and expertise related to behavioral health and chemical dependency... ...leadership for health plan and/or market specific... ...with regional medical directors to standardize... ...utilization management policies and procedures to improve...Remote workPolicyHealth InsuranceWork at officeLocal area
$268k - $414k
...Behavioral Medical Director The Behavioral Medical Director... ...Psychiatrists, Behavioral Health Providers, and other... ...collaboratively with the Health Plan Medical Director,... ...flexibility to work remotely from anywhere within... ...Group's Telecommuter Policy. Equal Employment Opportunity...Remote workPolicyHealth InsuranceMinimum wageWork experience placementLocal area$248.5k - $373k
...clinicians work and live.The Medical Director for Utilization... ...fulfillment of advancing the health of your community with... ...flexibility to work remotely * from anywhere within... ...needs of the health plan members and... ...medicine guidelines, and UM policies and procedures with counsel...Remote workPolicyHealth InsuranceMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home$119.47 - $179.33 per hour
...will directly improve health outcomes by connecting... ...The Healthy First Steps Medical Directors (HFS MDs) team is... ...facilitate discharge planning. The HFS MD will join... ...the flexibility to work remotely from anywhere within the... ...Group's Telecommuter Policy. Compensation for this...Remote workPolicyHealth InsuranceHourly payDaily paidMinimum wageWork experience placementLocal areaWeekend work$79.8k - $126k
...Medical Director - Texas Licensed (5pm-9pm CT) Remote Judi Health is an enterprise health technology company providing a comprehensive... ...for employers and health plans, including: Capital Rx , a public... ...to Capital Rx’s coverage policies. Medical Directors represent the...Remote workPolicyHealth InsuranceWork at officeLocal areaShift work$258k - $323k
...to apply for the Behavioral Medical Director - Remote role at Optum 1 day ago... ...team will directly improve health outcomes by connecting people... ...collaboratively with the Health Plan Medical Director, Clinical,... ...Group’s Telecommuter Policy Compensation for this specialty...Remote workPolicyHealth InsuranceMinimum wageFull timeWork experience placementLocal area$268k - $414k
...will directly improve health outcomes by connecting... ...together. The Behavioral Medical Director position is... ...collaboratively with the Health Plan Medical Director,... ...the flexibility to work remotely from anywhere within... ...Group's Telecommuter Policy Compensation for...Remote workPolicyHealth InsuranceMinimum wageWork experience placementLocal area$174.07k - $374.92k
...Medical Director (Medical Policy & Operations) Join to apply for the Medical Director... ...& Operations) role at CVS Health Medical Director (Medical Policy... ...6 company? This is a remote Work at Home position and can... ...Preferred Qualifications Health plan/payor experience....Remote workPolicyHealth InsuranceHourly payFull timeTemporary workLocal areaWork from homeFlexible hours$174.07k - $374.92k
...building a world of health around every... ...care resources. Remote based (work from home... ...Arizona and have a medical license without encumbrances... ...) In the Medical Director role you will... ...for medical policy implementation. You... ...experience with a Health Plan / Payor. Previous...Remote workPolicyHealth InsuranceHourly payFull timeTemporary workLocal areaWork from homeNight shiftWeekend work- ...business solutions for health care professionals... ...reach that medical businesses need to... ...with an exceptional remote workforce across the... ...to health plans, and processing over... ...Engineering, the Medical Director will lead a team... ...of payer medical policy guidelines, the construction...Remote workPolicyHealth InsuranceHourly payWork at officeLocal area
$325.3k
...career. Executive Medical Director, US Medical Lead -Obesity... ...and lifecycle medical planning. You will serve as... ...guidance, and company policies. This individual... ...evidence-generation, health economics and outcomes... ...posting. This role is a remote role. As an organization...Remote workPolicyHealth InsuranceFlexible hours- Position: Associate Medical Director - Health Plan Full/Part Time: Full time Location: Houston, TX, US Department: Medical Affairs Shift: 8a... ...be responsible for establishing health plans and medical policies. The Associate Medical Director provides guidance to areas...PolicyHealth InsuranceFull timePart timeWork at officeLocal areaShift work
$250k
The Utilization Review Medical Director is responsible for conducting clinical reviews... ...and Medicaid guidelines, health plan-specific criteria, internal policies, and regulatory requirements. This... ...Additional Expectations Full-time remote role requiring consistent...Remote workPolicyHealth InsuranceFull timeTemporary workLocal area$223.8k - $313.1k
Behavioral Health Medical Director page is loaded## Behavioral Health Medical Directorlocations: Remote Ohiotime type: Full timeposted on: Posted Todayjob... ...clinical guidelines, state policies, CMS policies and... ...case management in a health plan setting* No current sanction...Remote workPolicyHealth InsuranceWeekly payFull timeTemporary workApprenticeshipWeekend work$121.7k - $202.9k
...Express Scripts Inc. (ESI) Health Plans Division (HPD) Operation Director (OD), you will provide... ...and mentoring on-site and remote team members Work collaboratively... ...benefits including medical, vision, dental, and... ...Group has a tobacco-free policy and reserves the right not...Remote workPolicyHealth InsuranceFull timeWork experience placementWork at officeLocal areaWork from homeShift workNight shift
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